ESIS Senior Workers Compensation Claims Representative
Location: Wilmington, Delaware
Description: Ace Group is currently seeking to employ ESIS Senior Workers Compensation Claims Representative right now, this position will be delegated in Delaware. For detail informations about this position opportunity please read the description below. Sr Claims Representative
Under the direction of the Claims Team Leader investigates and settles claims promptly! , equitably and within established best practices guidelines.
MAJOR DUTIES & RESPONSIBILITIES:
Duties include but are not limited to:
- Under limited supervision, Receives assignments and reviews claim and policy information to provide background for investigation and may determine the extent of the policy’s obligation to the insured depending on the line of business.
- Contacts, interviews and obtains statements (recorded or in person) from insureds, claimants, witnesses, physicians, attorneys, police officers, etc. to secure necessary claim information.
- Depending on line of business may inspect and appraise damage for property losses or arranges for such appraisal.
- Evaluates facts supplied by investigation to determine extent of liability of the insured, if any, and extend of the company’s obligation to the insured under the policy contract.
- Prepares reports on investigation, settlements, denials ! of claims, individual evaluation of involved parties etc. !
- Sets reserves within authority limits and recommends reserve changes to Team Leader.
- Reviews progress and status of claims with Team Leader and discusses problems and suggested remedial actions.
- Prepares and submits to Team Leader unusual or possible undesirable exposures.
- Assists Team Leader in developing methods and improvements for handling claims.
- Settles claims promptly and equitably.
- Obtains releases, proofs of loss or compensation agreements and issues company drafts in payments for claims.
- Informs claimants, insureds/customers or attorney of denial of claim when applicable.
- Demonstrated workers compensation claims investigation/adjusting experience and technical competence, including knowledge of applicable state/local legislation.
- Knowledge of PA Workers' Compensation, NJ Workers' Compensation, and some knowledge of DE Workers' Compensation.
- A! bility to work independently, while assimilating various technical subjects, as evidenced by successful completion of a college-level curriculum or equivalent practical work experience.
- Effective communications, negotiations and interpersonal skills to be capable of dealing with insureds in a positive manner concerning losses, and to be able to deal with outside investigative sources, public officials and attorneys, as well as other personnel.
- Must be able to operate effectively in a team environment.
- Demonstrated skill in the following competencies: Control of Process - Works to establish and maintain control of claim resolution. Forward Thinking - Takes steps to control or minimize current exposure and future risks. Influence - Uses strategies to persuade or get others to take a desired action. Behavioral Versatility - Adapts own approach or behavior to a particular situation. Diagnostic Skills - Identifies critical relationships between events ! or facts. Strategic Inquiry - Gathers or verifies critical information.! Objectivity - Considers various options and other perspectives in coming to a conclusion. Interpersonal Astuteness - Recognizes the perspectives and capability of others. Concern for Image - Builds and maintains positive image for ESIS. Customer Service - Responds to and supports customer needs. High Personal Standards - Committed to high standards of behavior and performance. Confidence - Believes in own judgment and acts to support and defend choices.
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If you were eligible to this position, please give us your resume, with salary requirements and a resume to Ace Group.
Interested on this position, just click on the Apply button, you will be redirected to the official website
This position starts available on: Fri, 29 Mar 2013 14:26:19 GMT
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